Organization
VICTORINA'S DIABETES ENDOCRINOLOGY AND METABOLISM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILFRED MARCO VICTORINA M.D. (PRESIDENT)
(859) 496-1803
Entity
Organization
Contact information
Practice address
4879 PALM COAST PKWY NW, UNIT # 2, PALM COAST, FL 32137-3672
(386) 225-4462
Mailing address
PO BOX 350812, PALM COAST, FL 32135-0812
(386) 225-4462
(386) 225-4465
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
ME126126
FL
Other
Enumeration date
09/04/2016
Last updated
04/06/2017
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